Book Review: Canadian and American Women: Moving from Private to Public Experiences in the Atlantic World

Review of Canadian and American Women: Moving from Private to Public Experiences in the Atlantic World, edited by Valeria Gennara Lerda and Roberto Maccarin

Borrowed Halos: Canadian Teachers as Voluntary Aid Detachment Nurses during the Great War

Teaching and nursing were frequent career choices for unmarried, middle-class women in the Great War era, but only nurses were eligible for active service in Canadian military hospitals overseas. Teachers were expected to remain at home, volunteering for patriotic projects like other women. This role proved too passive for some, who relinquished their careers to become, temporarily, Voluntary Aid Detachment nurses (VADs); many served in British military hospitals overseas. The history of this unique group offers new insights into societal expectations for Canadian women’s professional work in the early twentieth century. The transformation of teachers into nurses during the crisis of war was legitimized by the substitution of gender and class attributes for specialized training, allowing women teachers the otherwise unattainable opportunity for active service abroad. Their experience raises important issues regarding the meaning of “professional identity” in traditional women’s occupations, and professional development later in the century.L’enseignement et le soin des malades étaient les principales carrières que choisissaient les femmes célibataires de la classe moyenne à l’époque de la Grande Guerre mais, seules les infirmières étaient éligibles au service actif, accompli au sein des hôpitaux militaires outre-mer. On s’attendait à ce que les institutrices restent à la maison et, comme les autres femmes, se portent volontaires pour des projets patriotiques. Ce rôle s’avérait trop passif pour certaines, qui renoncèrent à leurs carrières pour former, temporairement, un corps d’aidesinfirmières volontaires; plusieurs servirent outre-mer dans les hôpitaux militaires britanniques. L’histoire de ce groupe particulier permet de découvrir de nouvelles facettes des attentes sociales à l’égard du travail professionnel des femmes canadiennes au début du XXe siècle. La transformation des institutrices en infirmières durant la guerre était légitimée par le remplacement des qualités de genre et de classe pour permettre la formation spécialisée, offrant aux institutrices une occasion autrement inaccessible d’accomplir un service actif outre-mer. Leur expérience soulève d’importantes questions sur la signification de l’identité professionnelle des occupations féminines traditionnelles et du développement professionnel qui survint après la guerre

“Sharing the Halo”: Social and Professional Tensions in the Work of World War I Canadian Volunteer Nurses

The experience of some 500 Canadian and Newfoundland women who served overseas as Voluntary Aid Detachment (VAD) nurses during the Great War has been eclipsed by the British record. Sent as auxiliary assistants to trained nurses in the military hospitals, Canadian VADs confronted a complex mix of emotional, physical, and intellectual challenges, including their “colonial” status. As casually trained, inexperienced amateurs in an unfamiliar, highly structured hospital culture, they were often resented by the overworked and undervalued trained nurses, whose struggle for professional recognition was necessarily abandoned during the crisis of war. The frequently intimate physical needs of critically ill soldiers also demanded a rationalisation of the VAD's role as “nurse” within a maternalist framework that eased social tensions for both VAD and patient. As volunteers assisting paid practitioners, the Canadian VAD experience offers new insights into a critical era of women's developing professional identities.L'expérience de quelque 500 femmes canadiennes et terre-neuviennes qui, pendant la Grande Guerre, ont servi outre-mer en tant qu 'auxiliaires volontaires, a été oblitérée dans les registres britanniques. Envoyées dans les hôpitaux militaires comme assistantes des infirmières diplômées, les auxiliaires volontaires canadiennes étaient placées devant des défis d'ordre émotif, physique et intellectuel, auxquels leur statut de ressortissantes d'une colonie n'était pas étranger. Sommairement formées, et inexpérimentées dans un milieu hospitalier très structuré, elles subissaient souvent le ressentiment des infirmières diplômées surmenées et sous-estimées, dont la lutte pour la reconnaissance professionnelle avait été mise en veilleuse par la guerre. Les besoins physiques souvent intimes de soldats très malades exigeaient la rationalisation de leur rôle d'« infirmières » dans un contexte de maternage qui désamorçait les tensions sociales entre elles et les patients. En tant que bénévoles qui aidaient des professionnelles rémunérées, les auxiliaires volontaires canadiennes ont vécu une expérience qui jette un nouvel éclairage sur une époque qui a été critique pour l'acquisition d'une identité professionnelle par les femmes

Early Postoperative Death in Patients Undergoing Emergency High-Risk Surgery:Towards a Better Understanding of Patients for Whom Surgery May Not Be Beneficial

The timing, causes, and quality of care for patients who die after emergency laparotomy have not been extensively reported. A large database of 13,953 patients undergoing emergency laparotomy, between July 2014 and March 2017, from 28 hospitals in England was studied. Anonymized data was extracted on day of death, patient demographics, operative details, compliance with standards of care, and 30-day and in-patient mortality. Thirty-day mortality was 8.9%, and overall inpatient mortality was 9.8%. Almost 40% of postoperative deaths occurred within three days of surgery, and 70% of these early deaths occurred on the day of surgery or the first postoperative day. Such early deaths could be considered nonbeneficial surgery. Patients who died within three days of surgery had a significantly higher preoperative lactate, American Society of Anesthesiologists Physical Status (ASA-PS) grade, and Physiological and Operative Severity Score for the enumeration of Mortality and morbidity (P-POSSUM). Compliance with perioperative standards of care based on the Emergency Laparotomy Collaborative care bundle was high overall and better for those patients who died within three days of surgery. Multidisciplinary team involvement from intensive care, care of the elderly physicians, and palliative care may help both the communication and the burden of responsibility in deciding on the risk–benefit of operative versus nonoperative approaches to care

Veiled Concerns : Social and Professional Tensions of Voluntary Aid Detachments and Military Nurses during the 1st World War

Webcast sponsored by the Irving K. Barber Learning Centre and hosted by the UBC School of Nursing and the Consortium for Nursing History Inquiry. With only a brief training and minimal hospital experience, the VADs entered the unfamiliar world of the military hospital to work alongside the qualified Canadian military nurses at home, and British military nurses overseas, performing tasks that ranged from scrubbing floors and cleaning bedpans, to applying dressings and foments, and even assisting in the operating theatres. In this discussion Linda Quiney examines the boundaries that defined the VADs’ place at the bedside, the contested space of the wartime hospital wards, and the challenges they presented to the authority of the nursing professionals.Applied Science, Faculty ofArts, Faculty ofHistory, Department ofNursing, School ofUnreviewedFacultyResearche

CD47 Agonist Peptides Induce Programmed Cell Death in Refractory Chronic Lymphocytic Leukemia B Cells via PLCγ1 Activation: Evidence from Mice and Humans

International audienceBackgroundChronic lymphocytic leukemia (CLL), the most common adulthood leukemia, is characterized by the accumulation of abnormal CD5+ B lymphocytes, which results in a progressive failure of the immune system. Despite intense research efforts, drug resistance remains a major cause of treatment failure in CLL, particularly in patients with dysfunctional TP53. The objective of our work was to identify potential approaches that might overcome CLL drug refractoriness by examining the pro-apoptotic potential of targeting the cell surface receptor CD47 with serum-stable agonist peptides.Methods and FindingsIn peripheral blood samples collected from 80 patients with CLL with positive and adverse prognostic features, we performed in vitro genetic and molecular analyses that demonstrate that the targeting of CD47 with peptides derived from the C-terminal domain of thrombospondin-1 efficiently kills the malignant CLL B cells, including those from high-risk individuals with a dysfunctional TP53 gene, while sparing the normal T and B lymphocytes from the CLL patients. Further studies reveal that the differential response of normal B lymphocytes, collected from 20 healthy donors, and leukemic B cells to CD47 peptide targeting results from the sustained activation in CLL B cells of phospholipase C gamma-1 (PLCγ1), a protein that is significantly over-expressed in CLL. Once phosphorylated at tyrosine 783, PLCγ1 enables a Ca2+-mediated, caspase-independent programmed cell death (PCD) pathway that is not down-modulated by the lymphocyte microenvironment. Accordingly, down-regulation of PLCγ1 or pharmacological inhibition of PLCγ1 phosphorylation abolishes CD47-mediated killing. Additionally, in a CLL-xenograft model developed in NOD/scid gamma mice, we demonstrate that the injection of CD47 agonist peptides reduces tumor burden without inducing anemia or toxicity in blood, liver, or kidney. The limitations of our study are mainly linked to the affinity of the peptides targeting CD47, which might be improved to reach the standard requirements in drug development, and the lack of a CLL animal model that fully mimics the human disease.ConclusionsOur work provides substantial progress in (i) the development of serum-stable CD47 agonist peptides that are highly effective at inducing PCD in CLL, (ii) the understanding of the molecular events regulating a novel PCD pathway that overcomes CLL apoptotic avoidance, (iii) the identification of PLCγ1 as an over-expressed protein in CLL B cells, and (iv) the description of a novel peptide-based strategy against CLL